Book review – I Knew a Woman03/08/2009 at 5:39 pm | Posted in book review | Leave a comment
Tags: abuse, books, experts, female sexual dysfunction, Feminism, FSD, health, medicine, pregnancy, sex, Sexuality, surgery
Spoilers Warning! I’m talking about the contents here so if you’re inclined to read this one and don’t want to know what happens, go no further.
The best, briefest summary I can think of is: It’s a novelization of The V Book. (Awesome book, btw, every female bodied person & friend of female bodied persons should have a copy. I strongly recommend.)
I Knew a Woman is interesting – it is the first-person account of a female nurse practitioner, the author Davis herself, as she treats four female patients at a gynecology practice over the course of about a year. She treats other patients at the same time, but we follow only a unique four of them, as they touch base with the doctor every few weeks for follow ups to their initial health concerns. The patients are amalgams of many real ones Davis has actually treated. Real patients, mixed up in a blender & combined into semi-fictitious case studies. The women’s health concerns they face are pretty heavy – cervical cancer, teen pregnancy, drug abuse, and sexual pain & abuse.
For the most part, I Knew a Woman isn’t designed as self-help or a roadmap to female anatomy. The book adds some new information to my pool of women’s health knowledge, but not much. Most of what it does add, is little details of what to expect during a procedure I may have to encounter one day, and what goes on behind the scenes. Don’t get this book if you’re expecting a book that guides you step-by-step through your body & everything that can go wrong with it. Save your cash for something else if that’s the case.
For example, I already knew about the Os (opening of the cervix) and normal variations of tilted uteruses.
New information to me includes, I now know in great detail what to expect when the time comes for me to get my first mammogram.
I now have a better idea about what goes on behind the scenes of gynecolgic practice. The gossip, the social circles that form, the natural quirks that all individuals have & express at their jobs.
Since it takes the POV of a nurse practitioner, it gives patients an inside look at what goes on behind the scenes at the doctor’s office. I never know what happens after I go home from a doctor’s appointment. I know that records & sometimes prescriptions must be filled out & called in or faxed to pharmacies. But other then that, I didn’t know.
I Knew a Woman shows a patient (such as myself) what goes on after she goes home.
Some of it is … disturbing.
The monthly meeting of the, “Tumor Board,” a group of doctors who discuss the best course of action for patients who have been diagnosed with cancer – including our cervical cancer patient. The regimented hiearchy of doctors that make it up, each doctor firmly believing that his speciality has the best answer for newly diagnosed cancer patients.
The lazy clinic receptionist trying very hard to convince patients not to come in that day.
Davis’s thoughts about the patients & the judgments she makes about them. It’s disturbing, and she realizes that she’s not supposed to do it, either. But also humanizing. Nurses are human, too. They are not infallible. They silently pass judgments the same as you or I – even when we try to avoid doing so. Davis herself has known single motherhood & poverty, yet still sometimes she judges her single parent patients’ decisions. One Amazon.com editorial review itself explicitly states, “Some days she feels maternal toward Lila, other days she’d like to clobber her.”
This same editorial also points out that “[Davis is] ‘convinced that the cause of Joanna’s pelvic pain has more to do with a bruise in her soul than with an abnormality in her body.'”
So it may not just be my own self-consciousness acting up when I worry about the doctors talking about me behind my back after I go home from an exam as a pelvic pain patient. Maybe they worry about me. Maybe they pity me. It might really be happening. It’s somewhat reassuring… my paranoia is not completely unfounded.
Of particular interest is the pelvic pain patient, Joanna, who returns to Davis’ practice several times trying to determine the cause of & treatment for her dysparunia.
Once again, as with Let Me Count the Ways, the word “Vulvodynia” is never mentioned – leading me to question “Why is this book on the NVA reading list? It doesn’t talk about Vulvodynia.” The word “Vaginismus” does not appear either. I suppose the answer is because it gives that vital behind the scenes look at a doctor’s office. Makes it easier for pelvic pain patients to see how difficult it is for the doctor, too.
Joanna acts like I do at a gynecologist’s office – tense & straight to business, which seems to disarm doctors. Apparently it’s more unusual for patients to “Assume the position,” so to speak, for a gynecological exam without being instructed to do so, as Joanna and I do (31). Davis isn’t used to that.
Joanna and I wound up not having any “Easy” to treat issue causing pain with sex. No infections, lube didn’t help, nothing on the ultrasound, and repeat visits were fruitless for awhile. Sex just kept on hurting.
Eventually, the rapport between Joanna and Davis grows to the point where Joanna feels comfortable disclosing her history of childhood sexual abuse. It gets pretty graphic here. Suffice it to say, it is after addressing this long-forgotten sexual abuse that Joanna is able to begin sexual healing, with guidance from a therapist. The reader does not learn if she is ever able to fully resolve her problem, but judging from her more relaxed attitude at a subsequent exam, she found the right path for her.
Actually, all four of the female patients wind up being wrapped up with some kind of big red bow at the end. It’s not a “And they all lived happily ever after,” but the characters all see their crises resolved to a level of satisfaction. Lila has a healthy baby & leaves her abusive boyfriend & starts straightening out her life. Joanna seeks therapy for her history & perhaps her pelvic pain. Eleanor’s surgery is successful & she survives. Renee’s baby eventually thrives, she overcomes drug use and gets back some of her children that were taken away by the state.
I was kind of surprised that everything winds up being neatly tied up for the reader’s consumption in the end. In real life, it’s not always like that. Some problems last a lot longer than just one year. Lila’s going to have an armful as her child grows. But then, these patients are fictionalized. Davis must have taken some artistic license to make for a happy ending.
Although the book strongly focused on these four women – and Davis herself – there was one other woman who stood out very strongly.
I believe that there is a fifth woman.
This mysterious fifth woman appears in only one chapter, #21.
Davis’s clinic offered Maria, a domestic violence victim at the hands of her husband, some special services to her after the birth of her son. One nurse, Rita, makes periodic visits to Maria to check up on her, in more ways than one.
Maria left her husband, but he didn’t leave her. She dealt with stalking & harassment at work.
One day during a visit, Rita meets Maria’s husband. He reminds me of my own father – manipulative, abusive, and two-faced. Michael can wear a mask of friendliness & concern when there’s an audience. Strangers and even his own friends don’t know about the real person behind that mask. “Oh he doesn’t seem like such a bad guy.”
My father is like that. Wear the mask of an extroverted friend-in-waiting in public, but once he comes home, he takes it off & shows his true form.
It is a loud, scary, dangerous form.
And no one believes me or my mother when we try to explain this to our friends who know his other mask.
No one believed Maria, either, not even her nurse Rita.
She, too, is tricked into believing that Michael really isn’t that bad of a guy… “‘He sounded polite'” (147.)
Her gullibility leads to a violent situation, putting Maria in danger that only the police are able to resolve. But the violence did not end there.
It ended with Maria’s murder at her ex-husband’s hands.
This flashback takes place in the greater context of Davis showing that patients experience a myriad of problems in their own lives – including “Problems” for which the very word isn’t strong enough to describe.
This chapter just really stood out to me. I can relate to living with Michael… I’ve seen that one before… I wish more people would actually listen to victims of domestic violence & assault & just take them at face value.
Now since I Knew a Woman is on the NVA reading list, you may be asking, “Should I get this one?” If you can get copy in good condition for less than $20, then maybe. Like several of the books on thier list, this one is out of print, too, so you may have to order it used through a dealer. Best copy I could get ahold of still had some wear & tear on it.
But it’s a short book. I was able to burn through it within a few days. Won’t take very long, and you may find some reflections of yourself within. You may also like it if you like prose & poetry, as the writer is also a poet. Mostly I just like seeing another perspective of women’s health, from a nurse’s position.
A few caveats though: The women aren’t super-diverse and there aren’t any transfolk. I feel that some of Davis’ statements were a bit essentialist about women’s bodies & the body’s fate. Some parts may be triggering for women who have dealt with abuse. And again, as I said before, it’s not very useful in terms of actual treatment. If you’re on a book budget, or short on time, I would say, it’s nice, but optional.